Individual
DR. LEROY CARTER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2755 SILVER CREEK RD, SUITE 111, BULLHEAD CITY, AZ 86442-7904
(928) 704-7163
(928) 704-7140
Mailing address
2755 SILVER CREEK RD, SUITE 111, BULLHEAD CITY, AZ 86442-7904
(928) 704-7163
(928) 704-7140
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
26371
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
26371
NC
208600000X
Surgery Physician
Primary
41584
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412862
—
AZ
05
—
8977958
—
NC
Enumeration date
05/22/2006
Last updated
02/21/2012
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